Approved Hospital Formulary
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Approved Hospital Formulary
10/8/21 mt ICU Adult DKA Orders (PILOT MICU/NICU/SICU)
November 4, 2021
From: "Mickala M. Thompson" <mickala.thompson@hhsys.org>
To: "All Pharmacists" <grp_allpharm@hhsys.org>
Sent: Friday, October 8, 2021 12:31:09 PM
Subject: ICU Adult DKA Orders (PILOT MICU/NICU/SICU)
Good afternoon.
The current DKA insulin infusion protocol continues to lead to titration errors, despite the nursing double-check requirement. On October 12th, we will be piloting a new DKA Powerplan in MICU, NICU, and SICU - ICU Adult Diabetic Ketoacidosis (DKA) Orders (PILOT MICU/NICU/SICU). Please note that the existing DKA powerplan will still be available for housewide use. During this time, we will evaluate the pilot powerplan's efficacy and safety. Major updates in this plan include:
The current DKA insulin infusion protocol continues to lead to titration errors, despite the nursing double-check requirement. On October 12th, we will be piloting a new DKA Powerplan in MICU, NICU, and SICU - ICU Adult Diabetic Ketoacidosis (DKA) Orders (PILOT MICU/NICU/SICU). Please note that the existing DKA powerplan will still be available for housewide use. During this time, we will evaluate the pilot powerplan's efficacy and safety. Major updates in this plan include:
1) New target blood glucose range of 141-180 mg/dL,
2) Guidance to initiate the insulin infusion at a rate of 0.1 units/kg/hr (provider may still enter another desired rate), rounded down to nearest 0.5 units/hr,
2) Guidance to initiate the insulin infusion at a rate of 0.1 units/kg/hr (provider may still enter another desired rate), rounded down to nearest 0.5 units/hr,
3) Ability of the provider to select either a nurse-driven titratable insulin drip pathway OR a provider-directed fixed infusion, and
4) A new, simplified nursing titration protocol (if the nurse-driven pathway is selected).
Please see the attached for details and let me know if you have any questions or concerns. Thank you.
Please see the attached for details and let me know if you have any questions or concerns. Thank you.